Individual
BRIAN CHULMIN SHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 274-0275
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01088630A
IN
207L00000X
Anesthesiology Physician
A160652
CA
390200000X
Student in an Organized Health Care Education/Training Program
A160652
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102690063
ANTHEM PTAN
IN
05
—
300067911
—
IN
Enumeration date
03/31/2017
Last updated
12/02/2024
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